Author: Eli Greenspan, Policy Advisor for AAPPR through Foley Hoag, LLP

Last Updated: December 22, 2025

For more background on this policy, review our previous update HERE.

What is the latest?

On December 19, 2025, U.S. District Judge Beryl Howell heard from the U.S. Chamber of Commerce and Association of American Universities in their case challenging the Administration’s $100,000 fee on new H-1B visas. During the court proceeding, Judge Howell questioned the employer groups to demonstrate that the Administration is violating federal law, noting the President has broad powers to regulate immigration, including restricting entry of foreign workers.

While employers argued that the policy is disrupting recruitment plans for employers, Judge Howell sought to better understand how the groups are impacted by the policy, when the impact is more directly felt by prospective H-1B candidates. The Justice Department argued that the Administration is permitted to add preconditions to entry without consulting Congress.

While this would appear to be a setback, there have been other developments ratcheting up pressure on the Administration over this policy. This month, 20 states joined together to sue the Trump Administration over this policy, with California Attorney General Rob Bonta arguing that the Administration cannot rewrite immigration law. A broad coalition of schools and health providers also submitted two legal filings in federal court against this policy this week. This comes on the heels of an initial lawsuit led by a nurse staffing company challenging the Administration’s H-1B restrictions this fall.

Since Judge Howell did not offer any concrete timeline for a decision, we are continuing to work with national health stakeholders and Congress to urge the Administration to exempt health workers from the fee. Several members of Congress have reached out to the Administration call for an exemption, and we will continue to seek more outreach until we get a definitive response from the Administration.

What can you do?

AAPPR is exploring whether there is a viable path to relief that leverages the national interest authority with targeted congressional engagement. The Administration’s proclamation states that the Department of Homeland Security could waive the $100,000 fee if it determines the hiring of that H-1B worker is in the national interest and does not pose a threat to national security. That national interest standard provides a practical avenue for employers to seek tailored relief where the fee would impair continuity of care, exacerbate shortages, or otherwise impede access for patients.

AAPPR is already working with hospitals that have submitted H-1B applications and require letters of support highlighting the national interest standard as justification for waiving that fee. We can support your organizations with a similar letter or work with you to engage your Congressional delegation for a similar letter of support. Congressional engagement would be at its most beneficial when requesting an exemption from the fee.

Please share this with your legal counsel if you are encountering candidates eager to move forward or your organization is ready to pursue this pathway given the continuing uncertainty. We are happy to answer any questions.

For more information on this H-1B policy, you can review our last update here.